According to Marquis & Huston (2017) in a well-defined formal structure, roles and functions are defined and systematically arranged, different people have different roles, and rank and hierarchy are evident. I work for a not for profit Catholic hospital in Washington DC which organizational structure has a clearly defined authority and nursing responsibilities that contribute excellent work relationship.
The hospital’s organizational structure is the combination of bureaucratic or line structure and flat line. The hospital bureaucratic or line structure include the Health System President & CEO, Administrator & Vice President of Patient Care Services, Chief Marketing & Communications Officer, Senior Vice President & Chief Financial Officer, Director of Human Resources, Senior Vice President, Co-Chief Medical Officer, Physician Executive, President & CEO, Chief Strategy Officer, Chief Mission Officer, Senior Vice President, Co-Chief Medical Officer, and board of directors (provhosp, 2018). The hospital also has directors of various departments that report to the executive team above. The nursing units managers and clinical coordinators report to the nursing director. And the charges nurses and staff nurses report to the nursing unit manager. Marquis and Huston (2017) stated that the disadvantages of bureaucratic or line structure are that this design strictly adheres to the chain of command and this restricts upward communication.
The formal structure of the nursing department where I work can best be designated as flat. This is because it has few levels of management between the administration and staff level workers. Notably, the institution supervises the staff less while encouraging their augmented engagement in the decision-making course. As result, employees in the organization are more involved in the making of major decisions. Usually, the task of decision-making is not left entirely to the top management as employee committees are increasingly tasked with the making of decisions, which are then approved by the upper management (Yoder-Wise, 2014). In other words, the decision-making process in the organization can be termed as a decentralized one. This is because the department operates on entrustment of decision-making authorities along with flexible processes (Yoder-Wise, 2014). Often, the executive assigns tasks to management along with employees besides maintaining an increasingly open communication. This form of decision-making strategy is also reflected in the Emergency Department (ED).
The ED is headed by a manager. While the manager is given the freedom to run the department as he sees fit, he is held accountable for the decisions made within the department. Usually, the executive relies heavily on him to instill as well as manage the decision-making processes together with guidelines he has put in place (Yoder-Wise, 2014). For this reason, the manager is expected to involve all his employees in the decision-making processes within his department. However, the process of decision-making within the department is significantly influenced by the formal as well as the informal leadership.
The manager is the formal leader within the department. The manager controls as well as directs the decision-making process within the department. Notably, he assigns various groups with the tasks of coming up with certain decisions but dictates the direction of the conclusions. However, within the various groups are informal leaders selected by the group members who are tasked with spearheading the direction of the process according to the manager’s dictates. These informal leaders are much acceptable by the group and are mostly used by the manager to convey his thoughts and directions regarding the making of particular decisions within the department.
Conclusively, the flat organizational structure exhibited within the organization reflects the various departments. In the ED, the manager, being the formal leader greatly relies on the informal leaders within the group to convey his directions regarding the making of certain departmental decisions. Regardless, the decision-making process within the organization as well as within the ED department can be termed as decentralized as the employees are significantly involved in the process.
